Individual provider Active NPI

Carla Janeen Cavanaugh, LPN

  • Licensed Practical Nurse
  • Toledo, OH
National Provider Identifier
1477846178
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.109490 Issued in OH
Practice address
2912 Parkwood Ave
Toledo, OH 43610
Phone
(419) 356-9209
NPI assigned
May 27, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.109490 OH Primary

Addresses

Primary practice location

2912 Parkwood Ave
Toledo, OH 43610

Mailing address

2912 Parkwood Ave
Toledo, OH 43610
Phone (419) 356-9209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN.109490OHMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1477846178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 PARKWOOD AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43610",
            "telephone_number": "419-356-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 PARKWOOD AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43610",
            "telephone_number": "419-356-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "CARLA",
        "middle_name": "JANEEN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-27",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.109490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.